| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KELLER BENEFIT SERVICES, INC.3 | 7316 WISCONSIN AVENUE BETHESDA, MD 20814 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | $49K | $11K | $60K | 3.65% |
| EBCA3 | PO BOX 10100 MCLEAN, VA 22102 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | — | $11K | $11K | 0.70% |
| KELLER BENEFIT SERVICES, INC.3 | 7316 WISCONSIN AVENUE BETHESDA, MD 20814 | GUARDIAN LIFE INSURANCE COMPANY | $4K | — | $4K | 2.88% |
| KELLER BENEFIT SERVICES, INC.3 | 7316 WISCONSIN AVENUE, SUIRE 400 BETHESDA, MD 20814 | KAISER FOUNDATION HEALTH PLAN OF MID ATLANTIC STATES, INC. | $2K | — | $2K | 2.55% |
| EBCA3 | 1410 SPRING HILL ROAD MCLEAN, VA 22102 | KAISER FOUNDATION HEALTH PLAN OF MID ATLANTIC STATES, INC. | $1K | — | $1K | 1.45% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 109 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 23 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | 120 | $1.7M |
| Dental | GUARDIAN LIFE INSURANCE COMPANY | 114 | $145K |
| Vision | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | 120 | $1.6M |
| Prescription drug(2 contracts, 2 carriers) | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | 120 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 120 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.